Global Contraceptive Prevalence and Maternal Mortality – A Study of Women’s Reproductive Health

and Rights

ByOlufunke (Funke) Akiyode

Shout Global Health

info@shouthealth.com

Presenting Author’s Disclosure

No financial relationship

What are contraceptives?• Contraceptives are chemicals, medicines or device

that prevent conception8.• It is the use of any practices, methods, or devices

to prevent pregnancy from occurring in a sexually active woman3

• They are also known as Birth Controls or Fertility Controls, and Family Planning3.

• Contraceptive methods are either designed to prevent fertilization of egg or implantation of a fertilized egg in the uterus3.

• Methods can be reversible or irreversible

Contraceptive Type• 1. Continuous Abstinence4 – Not having sex• 2. Natural Family Planning / Rhythm Method – Not having

sex on most fertile days• 3.Barrier Methods – Sponge, cervical cap, diaphragm,

cervical shield, female condom, and male condom.• 4.Hormonal Methods- oral contraceptives, patch, shot/

injections, and vaginal ring• 5.Implantable Devices – Implantable rod, Interuterine

Devices (IUDs)9

• Permanent Birth Control Methods – Sterilization- surgical and inplant9

• 6. Emergency contraception – Used if primary birth control fails9.

Most Effective form of Contraceptive

• 1. Abstinence• 2. Condoms• 3. Birth control combination pill, patch or ring• 4. Progestin only pills• 5. Depo provera shot• 6. Implanon• 7.Inter uterine device• 8.Emergency contraception• 9 Essure5

Contraceptive Prevalence• The United Nations defined “contraceptive

prevalence as the percentage of women who are currently using, at least one method of contraception, regardless of the method used.7”

• Usually reported for women who are married or in union between ages 15 to 19

Contraceptive Prevalence

Computed as –Contraceptive Prevalence =

Women of reproductive age (15 – 49) who are married or in union and are currently using any method of contraceptive________________________________________________________ X 100

Total number of women of reproductive age (15 – 49) who are married or in union7

Global Contraceptive PrevalenceAny method Any

modern method

Sterilization Female Male

World 62.9 56.1 20.3 2.8

High IncomeCountries

69.7 58.6 8.1 4.8

Low IncomeCountries

61.7 55.7 22.3 2.5

Global Contraceptive Prevalence (CP)

• Contraceptive prevalence is generally higher in high income countries than in low income countries

• CP in high income countries is higher that the CP of the world

• There is a higher prevalence of sterilization among female than among males all over the world

• The rate of sterilization method is predominantly higher in low income countries than in high income countries

Contraceptive Prevalence (CP) by Regions

Any method

Any modern method

SterilizationFemale Male

Africa 28.0 21.9 1.5 0.0Asia 67.0 61.1 25.2 3.1Europe 70.5 56.3 3.8 2.6Latin America and the Caribbean

71.7 64.3 29.5 1.3

Oceania 58.6 52.5 12.1 9.9 7

Contraceptive Prevalence by Regions

• Africa has the least contraceptive prevalence in the world while Latin America and the Caribbean has the highest CP in the world.

• Sterilization is not popular in Africa and there is zero prevalence rate in sterilization method in males

• Asia has a slightly high CP and a high prevalence in female sterilization as a method of contraceptive

Contraceptive Prevalence and MMRContraceptive Prevalence

Maternal Mortality Rate

Africa 28.0 460Asia 67.0 150Europe 70.5 20Latin America and the Caribbean

71.780

Oceania 58.6 7 200 7

Global Contraceptive Prevalence (CP) and MMR

CP MMRWorld 62.9 210High IncomeCountries

69.7 16

Low IncomeCountries

61.7 240 10

Contraceptive Prevalence and MMR

• There is an inverse relationship between contraceptive Prevalence and Maternal Mortality.

• There is a high Maternal Mortality rates in region with low contraceptive prevalence

• Can we conclude that contraceptive prevalence might be one of the contributory factors of maternal mortality since more than a quarter of all pregnancies are unwanted?

Contraceptive Prevalence and Other Health Status IndicatorsCP Infant

Mortality Rates

Life Expectancy

Africa 28.0 70.76 11 5012

Asia 67.0 36.90 11 70 11

Europe 70.5 6.15 11 72 12

Latin America and the Caribbean

71.7 35 2 74 12

Oceania 58.6 17.53 11 72.7 13

Contraceptive Prevalence and Other Health Status Indicators

• Infant Mortality Rates are higher in regions with low contraceptive prevalence than in regions with high contraceptive prevalent rates.

• Life expectancy is lower in regions with low contraceptive rate than in regions with high contraceptive prevalence rate.

• Low heath status are an indication of a failed health system, therefore we may infer that low contraceptive prevalence is also an indication of failed health system

Global Contraceptive Prevalence (CP) and Abortion Rate

CP Abortion Rate

World 62.9 28High IncomeCountries

69.7 24

Low IncomeCountries

61.7 29 1

Contraceptive Prevalence and Abortion Rate

Contraceptive Prevalence

Abortion Rate

Africa 28.0 29Asia 67.0 28Europe 70.5 27Latin America and the Caribbean

71.732

Oceania 58.6 17 1

Global Contraceptive Prevalence (CP) and Abortion

• The higher the contraceptive prevalence, the lower the abortion rates and hence abortion deaths

• Unwanted pregnancy often times lead to Abortion.

• Abortion accounts for 13% of maternal mortality. 1

• These deaths rate can be greatly reduced with a high Contraceptive Prevalence.

Global Contraceptive Prevalence (CP) and Abortion

• The estimated number of deaths due to unsafe abortion in 2008 was 47,000.1

• When Eastern Europe made contraception widely available, abortion rate reduced by 50% 1.

• A woman’s likelihood of committing abortion is higher in the developing countries where the contraceptive prevalence is lower and where unsafe abortion is prominent.

Contraceptive Prevalence and Reproductive Health

• Reproductive Health has been defined according to the International Conference on Population and Development as a ‘state of complete physical, mental and social well being and not merely absence of disease or infirmity in all matters relating to the reproductive system and to its function and processes’

• In countries and places with low contraceptive prevalence women are more exposed to unwanted pregnancies, resulting in higher rate of maternal mortality, abortion rate and unsafe abortion.

Contraceptive Prevalence and Reproductive Health Rights

• Reproductive health rights as defined in the Beijing Platform of action are certain human rights recognized in the national and international legal and human rights documents, including the basic rights of all couples and individuals to decide freely and responsibly the number and spacing of their children, and to have information, education and means to do so; the right to make decisions concerning reproduction free of discrimination, coercion and violence

Contraceptive Prevalence and reproductive Health Rights

• Low contraceptive prevalence will deny couples “means” to freely decide the spacing and number of children they want to have, thus violating their RHR• Low contraceptive prevalence is an

indication of low access to family planning services which is a violation of reproductive health rights

Conclusions and Recommendations• Places with low contraceptive prevalence rates

tend to have high Abortion rate, unsafe abortion, abortion deaths and relatively high maternal mortality rate.

• Places with an improvement in contraceptive rates have experienced a considerable decrease in Abortion Rates and deaths.

Conclusions and Recommendation• Thus an increase in contraceptive prevalence will lead to decrease

In Abortion rates, unsafe abortion, and abortion deaths• Efforts should be made to improve contraceptive rates globally

(especially in the low income countries) in order to improve maternal mortality rates, reproductive health and rights.

• Efforts should also be made by countries to make effective form of contraceptives readily available.

• Countries should improve access to information on issues of contraception.

• The mass media can be used as a way to disseminate information about reproductive health needs.

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